10-09-2017, 04:09 AM
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AAPC Community Wiki: Diagnosis code of Hypertension

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Can anyone clarify the criteria for coding 405.99(Other unspecified secondary hypertension), and also let me know whether both 401.9 & 405.99 could be coded/billed together for the same patient on same date of service,

If the document states only secondary hypertension, you can add 405.99 since the reason for HTN not stated. And the Hypertension is documented as secondary that is specific than Hypertension NOS. So we can code only 405.99 since that is more specific.

Thanks for yr help Thara, so thus I understand that dx 405.99 can be coded alone if the document clearly reports as "secondary hypertension" but would you pls also confirm whether both 401.9 & 405.99 could be coded/billed together or not...

let me try to explain further:
401 is a category for essential hypertension - persistently high arterial blood pressure , - meaning above 140mm Hg systolic and 90 mm Hg diastolic; and without a discoverable cause. If the provider does not indicate benign or malignant in the documentation then it is coded as unspecified. - 401.9
405 is a category for secondary hypertension - elevated arterial blood pressure due to various primary diseases, - if it is not specified by the provider to be benign or malignant then it is coded as unspecified, and must be document as being due to renovascular disease or other disease. 405.91 or 405.99
You cannot code both 401.9 and 405.99
401.0 - 401.9 will be I10 in ICD-10
405 codes will be I18 codes in ICD-10.
Hopefully this will provide some assistance

I was also confused on this and the response given was very helpful. However, I have another scenario that I hope you can also help with. If the patient has secondary HTN in PMH and has Hypertensive Heart disease in the Assessment, would you just code the Hypertensive Heart disease only and not list the secondary HTN found in PMH even if there is a med in the chart to make it current? Thank you in advance for any assistance you may provide.

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